Awareness of Physiology Saveetha Dental College, Saveetha University,ChennaiEmail:

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Last updated: June 4, 2019

Awareness about Necrotizing Fasciitis among Student Population Type of manuscript:Original ResearchRunning Title:Awareness about Necrotizing Fasciitis P.Keshaav KrishnaaUndergraduate Student Saveetha Dental College, Saveetha University,ChennaiA.Jothi PriyaSenior Lecturer  Department of PhysiologySaveetha Dental College, Saveetha University, ChennaiCorresponding Author:A.Jothi PriyaSenior LecturerDepartment of Physiology Saveetha Dental College, Saveetha University,ChennaiEmail: [email protected] number:8939360922Introduction:Necrotizing fasciitis is any necrotizing soft tissue infection spreading along fascial planes with or without overlying cellulitis.1 It has also been described as a rapidly progressing necrotizing process accompanied by severe systemic toxicity.

2 Necrotizing fasciitis has been historically reported from almost all parts of the world and is now understood to be caused by either a single organism or more frequently by a variety of microbes — both aerobic and anaerobic.3,4. The first clear description was offered by Joseph Jones in 1971 5. The source of infection is variable but usually occurs after trauma or postoperatively.3,6,7,8 Frequently no history of trauma can be elicited.2 Seemingly insignificant and easily forgotten trauma, including minor lacerations, abrasions, or insect bites can initiate the process.

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8 Insignificant trauma in a marine environment leading to necrotizing fasciitis has been reported by Pessa.9As with many infectious diseases, three factors interact to produce an infection: factors related to the bacteria; factors related to the patient; and factors relating to the environment that brings them together — in this case, the nature of the injury.Patient factors associated with infection include impaired immunity, obesity and chronic diseases such as diabetes.Many patients report a preceding breach in the skin, through things such as surgery, accidental wounds, or intravenous drug use.Some types of infections are associated with particular settings.For instance, injuries occurring in marine environments, such as coral cuts, can be associated with particular types of bacteria that live in watery settings (such as Vibrio or Aeromonas).Unfortunately, early necrotising fasciitis is easily missed.

This is because the symptoms — fever, pain, swelling and tenderness at the affected site — may be non-specific or confused with a mild, superficial infection.The hallmark of necrotising fasciitis is pain far more severe than expected for what might otherwise look like a minor infection. Occasionally, some bacteria produce gas and this can be felt as “crackling” under the skin.

The infection can spread quickly — over minutes to hours — and deaths have been described within 24 hours in otherwise healthy people.The most important treatment for infections such as necrotising fasciitis or myositis is surgery to remove the dead tissue and as much of the bacterial burden as is possible. A combination of different antibiotics is usually used. A range of different bacteria may be implicated and each requires different antibiotics. Some antibiotics may also help switch off the toxins produced by bacteria.There is some interest in other secondary treatments, though these should be considered only after getting the patient to surgery, supporting failing organ systems and quickly administering the correct antibiotics.

Hyperbaric oxygen delivered in specialised compression chambers, for instance, aims to preserve living tissue and help the immune system combat infection. However, there is little good evidence that this helps.Similarly, intravenous immunoglobulin is a serum protein pooled from blood donors that may “mop up” toxin.

It is sometimes given for some types of necrotising fasciitis, although the evidence that it helps is also conflicting.Although the disease is a very cruel disease only very little knowledge is available about the disease among the population. Information on conditions such as this are very essential and thus the public must know about the implications of the particular disease.

This would help a well educated person to take well thought out decisions in the case of a medical proxy etc.Materials and Methods:The survey was conducted through an online basis. The survey consisted of questions which would educate the participant on the condition and also grasp on how much information they already posses. The initial question would rely on their present knowledge and the next question would be to educate the person on the same. The survey was circulated among the student population primarily in the health care field. The study was designed such that there would be no overlap of information between concurrent questions There were 82 responses which were obtained as part of the study. The results that were obtained through the survey was later analysed to obtain an updated knowledge on the same.

References:1. Ahrenholz DH. Necrotising soft-tissue infections. Surg Clin North Am. 1988;68:199–214. PubMed2.

Janeviscus RV, Hann S, Butt MD. Necrotising fasciitis. Surg Gynecol Obstet. 1982;154:97–102. PubMed3.

Giuliano A, Lewis F, Jr, Hadley K, Blaisdell FW. Bacteriology of necrotising faciitis. Am J Surg. 1977;134:52–7.

PubMed4. Changchien CH, Chen YY, Chen SW, Chen WL, Tsay JG, Chu C. Retrospective study of necrotizing fasciitis and characterization of its associated Methicillin- resistant Staphylococcus aureus in Taiwan. BMC Infect Dis.

2011;11:297. PMC free article PubMed5. Meleney FL. Hemolytic streptococcus gangrene. Arch Surg. 1924;9:317–64.6. Wilson B.

Necrotising fasciitis. Am Surg. 1952;18:416–31.  PubMed7. Lancerotto L, Tocco I, Salmaso R, Vindigni V, Bassetto F. Necrotising fasciitis: Classification, diagnosis, and management. J Trauma Acute Care Surg. 2012;72:560–6.

PubMed8.. Rea WJ, Wyrick WJ.

Necrotising fasciitis. Ann Surg. 1970;172:957–64. PMC free article PubMed9. 8.

Pessa ME, Howard RJ. Necrotising fasciitis. Surg Gynecol Obstet. 1985;161:357–61. PubMed


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